留存肾功能正常者^(99)mTc-DTPA显像参数正常值的建立

Normal reference of ^(99)mTc-DTPA renal dynamic imaging parameters of compensatory residual kidney

目的:建立一侧肾无功能或缺失、对侧肾功能代偿患者^(99)mTc-DTPA肾动态显像肾小球滤过率(GFR)、高峰时间(t_b)及半排时间(C_(1/2))正常参考值范围。方法:回顾分析115例单侧肾功能正常而对侧肾缺如或无功能检查者的^(99)mTc-DTPA肾动态显像结果,统计其GFR、显像剂摄取t_b及C_(1/2)。同时收集102例健康供肾者作为正常对照。结果:115例留存肾^(99)mTc-DTPA肾动态显像的GFR、t_b、C_(1/2)正常参考值范围分别为(37.19~102.58)m L/min、(2.10~4.23)min、(6.50~21.51)min。无论留存肾是左肾还是右肾,两者的GFR、t_b及C_(1/2)比较差异均无统计学意义(P>0.05)。留存肾GFR较供体肾代偿性增加(t=9.363,P<0.001)。留存肾t_b较供体肾延长(Z=3.595,P<0.001)。青年组、中年组和老年组组间GFR比较差异有统计学意义(F=6.130,P=0.003),青年组和中年组留存肾较供体肾GFR分别增加了47%和37%。结论:建立留存肾功能正常检查者^(99)mTc-DTPA显像GFR、t_b、C_(1/2)等参数的正常值参考范围,能够客观、有效地评价肾小球滤过功能,为临床诊疗提供依据。

Aim： To establish the normal reference range of compensatory residual kidney function parameters using ^（99）mTc-DTPA renal dynamic imaging. Methods： A total of 115 patients with normal unilateral renal function and the contralateral kidney non-function or received nephrectomy,and 102 donors（ control group） were collected. Parameters including glomerular filtration rate（ GFR）,the peak time of nephrogram（ tb） and half time of kidney washout（ C（1/2）） were collected.Results： The normal reference range of GFR,tb,and C（1/2） in 115 cases of renal ^（99）mTc-DTPA renal dynamic imaging were（ 37. 19-102. 58） m L/min,（ 2. 10-4. 23） min,（ 6. 50-21. 51） min,respectively. There was no significant difference in GFR,tb,and C（1/2） between the residual left and the residual right kidneys（ P〈0. 05）. GFR of the residual kidneys was statistically higher than that of donor kidneys（ t = 9. 363,P〈0. 001）. The tbof the residual kidneys was statistically longer than that of normal donor kidneys（ Z = 3. 595,P〈0. 001）. Compared with control group,GFR of the young group and the middle-aged group increased by 47% and 37%（ F = 6. 130,P = 0. 003）,respectively. Conclusion： The established normal reference range of GFR,tb,C（1/2） based on ^（99）mTc-DTPA imaging could be impersonality and efficiency to evaluate glomerular filtration function,and provide a basis for clinical diagnosis and treatment.